Skeletal muscle relaxants are a heterogeneous group of medications commonly used to treat two different types of underlying conditions: spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions. The purpose of this report is to determine whether there is evidence that one or more skeletal muscle relaxant is superior to others in terms of efficacy or safety.

Contents

• Introduction
  • Scope and Key Questions
• Methods
  • Literature Search
  • Study Selection
  • Data Abstraction
  • Quality Assessment
  • Data Synthesis
• Results
  • Overview of included studies
  • Overview of systematic reviews and trials in patients with spasticity
  • Overview of systematic reviews and trials in patients with musculoskeletal conditions
  • 1. What is the comparative efficacy of different muscle relaxants in reducing symptoms and improving functional outcomes in patients with a chronic neurologic condition associated with spasticity, or a chronic or acute musculoskeletal condition with or without muscle spasms?
  • 2. What are the comparative incidence and nature of adverse effects (including addiction and abuse) of different muscle relaxants in patients with a chronic neurologic condition associated with spasticity, or a chronic or acute musculoskeletal condition with or without muscle spasms?
  • 3. Are there subpopulations of patients (specifically by race, age, sex, or different underlying conditions) with spasticity or chronic musculoskeletal conditions for which one skeletal muscle relaxant is more effective or associated with fewer adverse effects?
• Summary
• References
• Appendixes
  • Appendix A: Search Strategy
  • Appendix B: Updated clinical trials search results
  • Appendix C. Quality assessment methods for drug class reviews for the Drug Effectiveness Review Project
  • Appendix D. Quality abstraction tool for adverse events of muscle relaxants
• Evidence Tables

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.